{% extends "_base.htm" %}
{% block bodycontent %}
      <h1>New Account Request</h1>
      <p>
      Please enter your information below:
      </p>
      <form method="post" action="/apply">
      Name: <input type="text"  size="20"  maxlength="40" id="validate1" name="name" value="{{ name }}"/><span class="validInputclass" id="validInput1"> </span><br/>
      Account: <input type="text"  size="20"  maxlength="40" id="validate2" name="account" value="{{ account }}"/><span class="validInputclass"id="validInput2"> </span> <br/>
	  Email address: <input type="text"  size="20"  maxlength="40" id="validate" name="emailaddress" value="{{ emailaddress }}"/><span class="validInputclass" id="validEmail"> </span> <br/> <!-- zie http://www.reynoldsftw.com/2009/03/live-email-validation-with-jquery/-->
Password: 
<input type="password"  size="20"  maxlength="40" id="password"  name="password" value="{{ password }}"/><span class="validInputclass" id="validInput3"> </span>
<br/>
      <input type="submit" value="Create"/> 
      <input type="submit" value="Cancel" 
          onclick="window.location='/'; return false;"/>
      </p>
      {% ifnotequal error None %}
       <p>
       {{ error }}
       </p>
      {% endifnotequal %}
{% endblock %}


